Abstract
Background: Assessing patient reported outcomes (PRO) in conjunction with laboratory results inform better on the wellbeing of patients with human immunodeficiency virus (HIV) infection. We assessed PRO in relation to sociodemographic characteristics and viral load (VL) in HIV infected patients on antiretroviral therapy in a tertiary level hospital in Dar es Salaam, Tanzania.
Methods: This cross-sectional study enrolled adults who were on ART treatment for >six months. PRO was assessed using validated questionnaires. HRQoL was assessed using the EuroQol 5 Dimension 3 level (EQ-5D-3L) questionnaire whereby patients who reported any problem had poor HRQoL, while patients who reported no problem had good HRQoL. Adherence was assessed using a 7-day recall. Care satisfaction was assessed using patient satisfaction questionnaire short-form (PSQ-18). We recorded patients’ demographics and their current viral load.
Results: Of the 800 enrolled patients, 592 (74%) were female and in age group 30-59 [680/800, (85%)]. Overall 606/800 (75.75%) had good HRQoL as they reported no problem in all dimensions of EQ-5D-3L i.e. mobility, self-care, usual activities, pain and discomfort and anxiety or depression. Detectable VL was associated with problems across all the 5 dimensions. Most patients (83%) were generally satisfied with care, the mean score for general satisfaction was 3.84 ± 0.77, Cronbach’s alpha =0.72. Patients were dissatisfied with financial aspects of care (mean score 3.10 ± 0.65 Cronbach’s alpha=0.69). Most patients 693/800 (86.6%) reported high ART adherence of = 95%. Significantly majority of participants with high adherence 522/590 (88.47%) had undetectable VL, P value <0.001.
Conclusions: Participants in this setting reported good quality of life and high adherence to ART. High adherence was significantly associated with undetectable VL. Participants were dissatisfied with the cost of health care even though ART is provided free of charge in Tanzania.
Keywords
Patient reported outcomes, Health related quality of life, Care satisfaction, Adherence, HIV, AIDS disease, Viral load, CD4 count.